HEALTH reporter Warren Manger discovers how doctors in Coventry are pioneering an unusual way of injecting hope and happiness into the lives of children with cerebral palsy.

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“WE THOUGHT James would spend his whole life in a wheelchair, now he’s riding horses,” beams mum Sheila Stewart.

She proudly presents a photograph of James atop a magnificent brown stallion named Ben.

“It’s a miracle,” she enthuses.

It may be a transformation of Biblical proportions but this was no act of God. The 16-year-old actually owes his new lease of life to a drug that is more commonly known as a frivolous fashion therapy favoured by cougars and C-list celebrities.

Children in Coventry are now being given injections of Botox to treat their debilitating cerebral palsy.

The technique is being pioneered by Irene van der Ploeg, a children’s bone specialist and orthopaedic surgeon at University Hospital.

James, from Canley, was one of the first children in the UK to be given the treatment in his arms when he was six years old and has been a regular patient at the clinic ever since.

Sheila admits: “I was very nervous at first as I’d never heard of it before, but Ms van der Ploeg is amazing.

“She told us this treatment was the best thing she could do for James.

“Now as a joke I ask if I can have the rest of the Botox for my face if there’s any left over.”

Cerebral palsy affects one in every 400 children born in the UK. The incurable condition is often caused by damage to the brain before birth.

Many of the children born with cerebral palsy suffer muscle problems in their arms, legs or spine, leaving their limbs stiff or twisted.

For James it meant that his right wrist, hand and ankle slowly began to bend painfully out of shape.

Sheila says: “Five years ago James wouldn’t let anyone touch his arm.

“When he went out in his wheelchair people would stare and he would feel really self conscious.”

“Now he is much more confident.”

Doctors treating children with cerebral palsy already injected Botox in their legs, with promising results, but never used it on their arms. Yet Ms van der Ploeg maintains the latter offers at least as many benefits.

The surgeon is keen to teach other doctors how to use Botox to help children with cerebral palsy far beyond Coventry, running an annual course for other consultants.

Yet she remains anxious that desperate parents should not see the drug as a magic wand to make all their children’s problems disappear.

James - who starts a computing course at Herewood College later this year - will still need corrective surgery when he finishes growing.

He also continues to suffer from epilepsy (which is common in children with cerebral palsy) and quickly tires when he tries to walk due to years of muscle wastage in his legs.

This is because Botox does not treat the cerebral palsy itself, only some of the severe symptoms it causes.

Muscles grow because they are stretched by the growing bones. But if they are spastic they don’t lengthen properly, deforming the joints and even the bones themselves.

Botox temporarily blocks the spastic signals coming from the brain.

That means the muscles are more relaxed and easier to stretch, so the physiotherapy and splints the doctors use work much better. This in turn allows exercise to strengthen all the muscles in that area.

To illustrate this James happily removes the cast from his right wrist and shows us how much more comfortable and flexible his hand is.

It has been several months since his last injection so his hand has started to stiffen up again and he will soon need more treatment, but the results remain impressive.

Ms van der Ploeg stifles a smile as she fondly recalls a proud postcard that James sent from a family holiday. It’s a simple story that inspires the same unbridled enthusiasm in Ms van der Ploeg as it does in James and is a touching sign of the close bond she shares with her patients.

The holiday postcard told the doctor how James had walked down the beach with a bottle in his right hand for the first time.

“I don’t think it was full,” she says in a conspiratorial whisper. “But it was wonderful all the same.”

What is cerebral palsy?

* Cerebral palsy is a general term that doctors use to refer to a set of conditions that affect a child’s brain and nervous system. These are often caused before or soon after birth by:

- Infection early during pregnancy.

- A difficult or premature birth.

- Bleeding in the baby’s brain.

- Abnormal brain development in the baby.

* It is estimated than in every 400 children born in the UK are affected by cerebral palsy.

* It is not a progressive condition, so will not get worse as the child grows but often puts great strain on their body, which can cause problems in later life.

We’re so grateful for what they’ve done for Cerys...

The younger a child is when doctors begin using Botox to treat cerebral palsy, the better the results are likely to be.

This is because their bones and joints have deformed less, and their developing brain can adapt.

That is why little Cerys Maunsell-Stewart was given her first injections when she was just three years-old.

Botox has helped Cerys, from Styvechale, to develop enough dexterity in her fingers to hold a pencil – something James Stewart will never do.

She delights in demonstrating her skills to a willing audience, clutching a crayon and carefully writing her name and age on her pad for us.

Yet mum Marie – just like James’s mother – had doubts when Botox was suggested.

“I looked it up on the internet and saw the word, poison,” she recalls.

“But her doctor, Ms van der Ploeg, explained how important this was. So we thought it was worth giving it a go.”

Cerys, now aged five, only graduated from crawling on her belly to taking her first steps after beginning Botox.

Two years later she is a dancing diva who loves going to classes with her friends. She also enjoys swimming and, like James, has started horse riding to improve her balance.

The Grange Farm pupil still remains a little unstable on her feet and is prone to falling when tired.

She also (grudgingly) wears pretty, patterned splints on her legs and suffers wobbly “jelly legs” for several days after a course of Botox.

But such minor inconveniences are a world away from the life that would have otherwise awaited her.

“Without Botox and the leg splints Cerys will end up in a wheelchair,” explains Marie, who periodically punctuates our interview by reiterating how grateful the family are to the doctor and her team.

“We go back to the clinic every six to eight months and Ms van der Ploeg always speaks to Cerys and asks her if she wants the Botox.”

Marie admits she still does not know, or dwell upon, what the future will hold for Cerys. But thanks to Ms van der Ploeg and her pioneering injections there is a pinprick of light at the end of the tunnel for Marie and many parents like her.